Closure strategies post-EMR for esophageal SMTs

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Oncology

Background:

• Endoscopic mucosal resection (EMR) is a standard treatment for esophageal submucosal tumors (SMTs).
• Prophylactic clip closure of EMR wounds is common but lacks strong evidence for necessity and efficacy.
• This study evaluates clip closure versus non-closure after EMR for esophageal SMTs.

Purpose of the Study:

• To compare the clinical outcomes of prophylactic clip closure versus non-closure following EMR for esophageal SMTs.
• To assess the impact on postoperative complications, hospital stay, and costs.

Main Methods:

• Retrospective, single-center cohort study of patients undergoing EMR for esophageal SMTs.
• Patients were divided into clip closure and non-closure groups.
• Analysis included demographics, lesion characteristics, complications, hospital stay, and costs.

Main Results:

• 84 patients included (52 closure, 32 non-closure), with similar baseline characteristics.
• Minimal complications observed: one minor bleeding event in the closure group (1.9% vs. 0%; P=1.0).
• No significant differences in hospital stay (3.98±1.18 vs. 4.47±1.19 days; P=0.07) or costs (9745.08±3123.66 vs. 9180.34±2647.80 yuan; P=0.397).

Conclusions:

• Prophylactic clip closure after EMR for small esophageal SMTs (≤10 mm) offers no significant benefit over non-closure.
• Non-closure is a viable option, potentially reducing unnecessary interventions.
• Routine clip closure for these specific cases is not warranted.